The purpose of the proposed pre-doctoral and post-doctoral training program is to prepare nurse researchers, substantively and methodologically, to conduct research that is designed to improve the quality of health care and thereby contribute to the achievement of optimal patient outcomes. The Institute of Medicine's criteria for quality health care -- safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity -- provide the organizing framework for the proposed program. Upon completion of the program, trainees will be prepared to develop the evidence base to guide the provision of quality care, to evaluate that evidence, and to translate the evidence into the delivery of improved health care services and patient outcomes. The School of Nursing has partnered with the Department of Health Policy and Administration in the School of Public Health, and the Cecil G. Sheps Center for Health Services Research to bring together a strong group of extramurally funded faculty from nursing and related disciplines (Medicine, Social Work, Pharmacy and the Research Triangle Institute) for the proposed program. The proposed pre-doctoral training program builds on the current nursing doctoral program by preparing a beginning researcher with the knowledge and skills necessary to design and conduct research studies that advance the evidence base for improving the quality of health care and patient outcomes. Trainees will enroll in structured courses, participate in newly developed seminar series focused on quality and outcomes, and participate actively in multi-disciplinary quality- and outcomes-related research. Over the five years of the proposed training program, a total of 10 pre-doctoral trainees will be supported, with each trainee supported for 3 years. The proposed post-doctoral training program prepares an investigator to independently conduct studies to improve the quality of health care and enhance patient outcomes, using sophisticated conceptual theoretical frameworks, complex research designs, and/or advanced statistical techniques. A total of 6 post-doctoral fellows will be supported over the 5 years of the proposed training program, with each trainee supported for 2 years. Trainees will be involved in intensive and sustained multi-disciplinary mentored research programs focused on quality and patient outcomes and participate in quality- and outcomes-related seminars.